Psychological testing method and apparatus

ABSTRACT

A method for psychological testing of a subject is performed by (A) presenting a test by means of a testing means having output means (e.g. a computer monitor) and input means (e.g. a keyboard); and, (B) instructing the subject by displaying a simulation (as shown in the figure) of the test by means of said output means so that the subject can learn how to perform the test from the simulation. The test is therefore independent of the subject&#39;s language skills, or of verbal instructions provided by a supervisor.

FIELD OF THE INVENTION

The present invention relates to a method and apparatus forpsychological testing, of particular but by no means exclusiveapplication in the on-line testing of remote test subjects.

BACKGROUND OF THE INVENTION

Existing psychological testing techniques include memory tests, fluidintelligence tests, intelligence quotient tests and chronometric basedtests. Some said tests are available on-line at web sites such aswww.brain.com.

However, existing techniques have a number of shortcomings. Theseinclude the fact that verbal instructions must be used in demonstratingthe test to a test subject, such verbal instructions being presented tothe subject in printed or oral form. The subjects must then translatethe words into a state-dependent set of expectations about the type ofstimulus-response requirements that will be encountered in the test. Thetranslation process, however, is dependent upon the individual subject'slanguage skills in the language of the instructions, and that subject'sexperience in using language to govern his or her behaviour.

Further, instructions provided in this manner, either by theinterpretation of written instructions or by the verbal instructionprovided by a supervisor conducting the test (as well as subsequentinteractions between that supervisor and the test subject), can lead,almost inevitably, to the inadvertent altering of the test environment.This effect may be due to variations in the level of understanding bythe subject, or instruction or subsequent interaction provided by thesupervisor, who may conclude that more or less instruction, for example,is required for a particular subject. In some contexts this flexibilitymay be of value, but small changes in the test conditions can mask poorperformance or, alternatively, can impair normal performance.

Other existing techniques are culturally dependent: at the simplestlevel, the use of verbal or written instructions as discussed above canimpact on testing, because different instructions must be providedaccording to the language of the subject, thereby introducing variationdependent on the skill exercised in translating the instructions, andbecause some languages may be better adapted than others to expressingthe necessary instructions. Most existing techniques employ tests thathave a small number of forms, so that subjects repeating the test maysoon re-encounter a test, or may deduce the nature of the variationbetween tests and benefit accordingly.

It is an object of the present invention to provide a psychologicaltesting method and apparatus that avoids one or more of the aboveshortcomings.

SUMMARY OF THE INVENTION

The present invention provides, therefore, a psychological testingmethod for testing a subject, including:

-   -   performing said method by means of a test presented by means of        a testing means having output means and input means; and    -   instructing said subject by displaying a test simulation of said        test by means of said output means;    -   whereby said subject can learn how to perform said test from        said simulation.

Thus, the test subject may, but is not required, to read or listen toinstructions, or be instructed by a test supervisor in order to learnhow to perform the test.

Furthermore, in order actually to conduct the test, once learned, thetest subject will preferably perform the test without writteninstructions or instruction from a test supervisor.

Preferably, said method includes repeating said simulation a pluralityof times.

Preferably, said method is performed by means of a plurality of tests,and instructing said subject includes displaying a test simulation ofeach of said plurality of tests, whereby said subject can learn how toperform each of said tests.

Preferably, said method includes said subject performing said test byusing said input means after said subject is instructed.

Preferably, where said method is performed by a plurality of tests, saidmethod includes alternating between said subject being instructed andsaid subject performing a test.

Thus, the subject is instructed as to how to perform each testimmediately before performing that test.

Preferably, said method includes terminating said instructing of saidsubject and commencing assessing said subject when said subject is ableto satisfy a criterion of comprehension of the test. For example, thecriterion may be successful performance of three consecutive trialtests.

Thus, when the subject provides a response to a simulated test beforethe simulation itself displays the appropriate response, the methodceases instructing the subject and begins assessing the subject.

Preferably, said output means is a display means, and more preferably acomputer monitor, and the input means is a computer keyboard and/ormouse

However, the output means may be an audio output, or may be acombination of outputs.

Preferably, said test of said method includes displaying visual stimuli.

Preferably, said test of said method includes randomly varying a time atwhich said visual stimuli is displayed.

Preferably, said method includes measuring the response time of saidsubject.

Preferably, said method includes disregarding a response with less thana predetermined minimum response time.

Thus, if a subject anticipates the response, he or she may provide aresponse faster than is physically or psychologically possible (i.e.below a base level reaction time), so that response should preferably bedisregarded.

Preferably, the method includes presenting substantially a culturalstimuli to said subject. More preferably said stimuli compriserepresentations of playing cards, dominoes, playing counters, or similarwidely recognised game playing indicia.

Preferably, displaying said test simulation includes displaying thecorrect use of said input means to perform said test.

The invention also provides psychological testing apparatus for testinga subject, said apparatus including testing means having output meansand input means, said testing means testing said subject by presenting atest to said subject, said apparatus instructing said subject bydisplaying a test simulation of said test on said output means, wherebysaid subject can learn how to perform said test by means of saidapparatus from said simulation.

Preferably, said testing means is a computer programmed to present saidtest to said subject. It will be understood that the term “computer” canencompass any appropriate computing device or combination of computingdevices, for example, a stand-alone computer or the combination of ahost computer and a client computer.

Preferably, said output means is a display means and more preferably acomputer monitor and said input means is a keyboard.

The invention also provides a method of monitoring the performance of asubject using the above psychological testing method, includingobtaining a reference test result by a subject performing the testingmethod repeatedly until said subject is satisfied that they haveperformed said testing method at a near optimum level and using theresult of the test performed at a near-optimum level as a reference testresult;

obtaining a comparison test result by a subject performing said testingmethod repeatedly at a time at which the subject's performance is to bemonitored until said subject is satisfied that they have performed thetesting method at a near optimum level, and using the result of the testperformed at a near optimum level as a comparison test result; and

comparing said comparison test result with said reference test result tothereby monitor the performance of the subject.

Thus, any deterioration in the subject's performance can be noted.

Preferably, said method includes obtaining a number of comparison testresults and using said comparison test results to monitor said subject'sperformance.

The invention also provides apparatus for monitoring the performance ofa subject using the above psychological testing apparatus, wherein saidapparatus obtains a reference test result by allowing a subject toperform the test repeatedly until said subject provides an input viasaid input means which indicates that the subject is satisfied thathe/she has performed said testing method at a near optimum level,wherein said apparatus includes a storage means for storing said resultof the test performed at a near optimum level as a reference test resultfor said subject;

said apparatus obtaining a comparison test result by allowing a subjectto perform said test repeatedly at a time at which the subject'sperformance is to be monitored until said subject provides an input viasaid input means which indicates that said subject is satisfied thatthey have performed the testing method at a near optimum level,

said apparatus retrieving the stored reference test result and comparingsaid comparison test result with said reference test result to therebymonitor the performance of the subject.

The present invention further provides a psychological testing methodfor testing a subject, including:

-   -   performing said method by means of a plurality of tests        presented by means of a testing means having output means and        input means;    -   measuring for each of said tests a response time of said        subject; and    -   determining changes in said response times over the duration of        said tests.

Preferably, said method includes disregarding any of said response timeswith less than a predetermined minim response time.

The present invention further provides psychological testing apparatusfor testing a subject, including:

-   -   a testing means having output means and input means, said        testing means testing said subject by presenting a plurality of        tests to said subject;    -   said testing means measuring for each of said tests a response        time of said subject; and    -   said testing means determining changes in said response times        over the duration of said tests.

Preferably, said testing means disregards any of said response timeswith less than a predetermined minimum response time.

The method and apparatus of the invention are suitable for administeringa variety of psychological tests, including but not limited to tests ofcognitive ability, memory function, decision-making function,concentration function, and problem-solving function. These tests areuseful for assessing cognitive ability and/or its impairment by factorssuch as fatigue, alcohol intake, intake of drugs of abuse or therapeuticdrugs, or underlying medical conditions which affect cognition. Themethod and apparatus of the invention are thus useful in assessingsuitability of personnel to perform demanding tests, eg militarypersonnel, airline pilots, sportspersons, or transport drivers. It willbe appreciated that the test can also be used in a clinical setting, forexample to measure a decline in performance resulting from progressionof a clinical condition, or an improvement in such a condition resultingfrom therapeutic intervention (eg drug treatment).

BRIEF DESCRIPTION OF THE DRAWINGS

In order that the present invention may be more clearly ascertained, apreferred embodiment will now be described, by way of example, withreference to the accompanying drawings, in which:

FIG. 1 shows a logon screen of the invention;

FIG. 2 shows a screen used to create a new user entry;

FIG. 3 shows a screen used to enter subject details;

FIG. 4 shows initial instructions to be provided to the subject;

FIG. 5 shows a keyboard simulation and a response meter;

FIG. 6 shows how to use a simple reaction test;

FIG. 7 shows cards used in a congruent test;

FIG. 8 shows cards used in a continuous monitoring test;

FIGS. 9A and 9B show cards used at a pair card matching test withincidental memory; and

FIGS. 10A and 10B show cards used in an associate learning test.

DESCRIPTION OF THE PREFERRED EMBODIMENT

In the preferred embodiment, psychological testing apparatus forcarrying out a psychological testing method for testing a subject isprovided in the form of a computer program loaded onto a personalcomputer, whereby the personal computer (PC) provides output means, inthe form of a computer monitor, and input means in the form of akeyboard and/or mouse—the personal computer is loaded with software thusproviding a testing means. The computer program can be preloaded on thePC or downloaded from the Internet, for example, in the form of a Javaapplet. It will be appreciated that the software resident on the PC mayonly be part of the software. For carrying out the software method. Forexample, the psychological testing may be carried out over the Internet,in which case a likely configuration is that a part of the software willrun on the host computer and a part of the software will be resident onthe PC or client computer, with data generated by the software runningon the client computer being automatically transmitted to the hostcomputer. Thus, results generated by the testing apparatus can be storedin a memory associated with the host computer at a site remote fromwhere the test is carried out.

Once a series of introductory steps have been completed, such as thelaunching of the software and a series of registration steps have beencompleted, the psychological testing method begins. The method operatesessentially by instructing the subject by displaying a test simulationof each test on the computer monitor whereby the subject can learn howto perform the test from the simulation.

The test simulation includes displaying on the computer monitor thecorrect use of the keyboard, which is the preferred input means, toperform the test. Thus, from observing the simulation, the subject canlearn how to use the keyboard to perform the test correctly. While thetest subject is not required to read or listen to instructions or to beinstructed by a test supervisor in order to perform the tests, it willbe clearly understood that verbal or written instructions may optionallybe provided, even though reference to such instructions need no be madein order to understand how to perform the test as this can be learntfrom the simulation.

An example of how the testing method could be performed is now given inorder to facilitate understanding of the broad inventive concept, aswell as a number of other inventive features of the psychologicaltesting method and apparatus.

The subject to be tested sits at a comfortable viewing distance in frontof a personal computer loaded with the computer program. Each PC canonly test one subject at a time. A test usually lasts about 15-20minutes. The program is initiated, eg by double clicking the associatedapplication icon, and the monitor displays. A dialog box (2) as shown inFIG. 1 with buttons 3 displaying the available options.

These include options to start a new test (“New Test . . . ”) 3 a,retest a subject already tested at least once before (“Retest . . . ”) 3b, view the on-line help information (“Help . . . ”) 3 c, e-mailprevious completed test results for analysis (“Mail Tests . . . ”) 3 d,adjust the program's settings (“Settings . . . ”) 3 e, or leave iThinkimmediately (“Quit”) 3 f. If this dialog box 2 is dismissed by selectingone of the options, these items have menu equivalents which can beselected to perform similar actions without the need for the dialog box2. The provision of appropriate equivalent menu items as well as thedialog is within the skills of a computer programmer and hence notdescribed in further detail.

Usually, a subject will click either the “New Test . . . ” button 3 b(or the equivalent menu item) to begin a new test, or the “Retest . . .” button 3 c if they have prior test data or formerly cancelled a testwithout completing it. If they wish to view the on-line help or adjusttest settings they can click the respective buttons (and can then choosethe equivalent menu items to initiate or continue testing ie. “NewSubject . . . ” for “New Test . . . ”, “Open Subject . . . ” for “Retest. . . ”).

Once a subject initiates a new test, they must first create a subjectfile into which their details and test data will be saved at thecompletion of the test. They will be presented with a standard save filedialog box 5 as shown in FIG. 2. The subject can navigate to a folder oftheir choice (usually determined by the supervisor) or use the defaultsetting (where a file was saved last time). The subject needs to type intheir name or some other file name identifier 7 and then click the Savebutton 9 to save this file.

They are next presented with a subject details dialog box 10 (FIG. 3)with editable fields 11 requesting personal information such as: prefix11 a, first name 11 b, last name 11 c, title 11 d, company 11 e, a firstaddress line 11 f, a second address line 11 g, city 11 h, state 11 i,zip code 11 j, country 11 k, phone 11 l, fax 11 m, e-mail address 11 n,birth year 11 o. If desired, a code name or number or minimumidentification details may alternatively be used. Certain fields aremandatory and must be completed to continue. In addition there are anumber of pop-up menus for details which have a limited number ofresponses and which may affect the conducting of the testing method orthe results of the testing method or be useful for analysis of resultsof a number of testing methods. These menus include gender menu 13 awith possible selections of male or female; handedness menu 13 b withselections of right—2 hands, left—2 hands, ambidextrous, right—1 hand,and left—1 hand; and a education 13 c with selection of primary,secondary or tertiary.

When the subject's details have been entered, the subject is required toset a password which must be entered in order to verify that the subjectis performing the test.

Test data is recorded in a log window which is invisible to the subjectusing text codes and times. Appropriate test data recording techniqueswill be apparent to those skilled in the art and further details are notprovided herein.

Once the initial registration steps have been carried out, anintroductory screen of instructions including a plurality ofinstructions 17 may be displayed in order to provide some indication asto how to respond to the overall testing method, without explaining howindividual tests of the testing method should be performed. Thisexplanation being left to simulation of the tests. This screen 15 neednot be displayed in all embodiments.

Each test of the testing method can include two distinct phases: asimulation phase in which the test is shown to the subject and a testingstage when the subject performs the test in accordance with the ruleslearnt during the simulation stage.

Each test is based on the display of virtual playing cards as visualstimuli. Playing cards are chosen as they are generally a cultural andalso contain a number of levels of information. The tests involvedifferent presentation of the playing cards on the display to the userin order to measure different aspects of cognition. when a test issimulated a keyboard is represented on the display with overlying handsas shown in FIG. 5. In some of the tests a response meter 21 is providedto give the user feedback as to their speed of response to part of thetest or demonstration. In each test, the simulation phase includesdisplaying cards in a particular manner and indicating by highlighting arelevant section of the display of the keyboard how the user shouldrespond to the test. The response meter provides a further indication asto whether the user is responding sufficiently rapidly. Specifically,the response meter includes a coloured graphic bar which moves as timepasses to give an indication of the time passed and the urgency ofresponding.

In general, in all tests, one or more packs of face-down cards willappear centrally on the display of the computer monitor. At some randomtime cards will turn face-up on top of the pack or beside the pack. Eachcard will require a specific response by the subject—i.e. by pressingone key of the keyboard. Depending on the handedness selection made inthe subject details dialog box 10, different keys will be designated as“true” or “false” and the keys are chosen to ensure that the dominanthand is used to answer the “true” condition. The correct key isdetermined by the rules of the test. In most tests there are only twokeys to choose from. In some tests there is only one key and in sometests there are three keys to choose from. Typically, if the user isright handed then the “true” key will be on the right hand side of thekeyboard.

More complicated tests may be devised which require the pressing of alarger number of keys if this is appropriate to the tests concerned.

In each test, the keyboard representation 19 will appear during thedemonstration but will also reappear after a run of consecutiveincorrect responses. Each test consists of a plurality of trials—i.e. arepetition of the test and the reaction time for each trial is recordedfrom 100 ms after the appearance of the face-up card(s) until a keyboardresponse is received.

Visual feedback is given to the subject which varies depending uponwhether the response was correct or incorrect with cards returning totheir deck in a different way, for a correct response and an incorrectresponse. An incorrect response may also illicit a sound. By providingvisual feedback, the testing method provides the subject with anopportunity to learn as they go and correct their responses to varioustests.

A number of tests are then performed.

1. Keyboard Key Test

Aim: To train the subject in response accuracy and speed using thekeyboard.

The keyboard 19 and response meter appear 21 with 3 keys outlined inred. In FIG. 5, for a right handed subject these keys are the true 25,false 25 and space bar 27 keys, however any are easily used incombination. These keys initially flash sequentially twice to attractattention to them and then the hands (30, 29) appear from below andslide into the correct hand position. Specific keys then highlight in arandomized order. The subject is expected to press the highlighted key(23, 25, 27) as quickly as possible. The keys highlight every 1500-1700ms. The response meter's internal coloured graphic 22 rises at a steadyrate until the subject responds in order to provide an indication thatthe user should respond. It then stops so that they can inspect thecolour achieved as a measure of their speed of response, and the keyhighlight disappears. For incorrect key presses, an error buzzer alsosounds. No cards appear in this test and the keyboard remains throughoutthe subtest.

The test continues until each key has been pressed 3 times each, or atleast once each and a total of 9 keys have been correctly pressed, ortime runs out (60 seconds). Anticipatory and post-stimulus feedbackerrors (key responses) are also recorded.

Trial Settings:

Total required successes=9

Stimulus Start=1500 ms

Stimulus Stop time=0 ms

Feedback duration=200 ms

Post-ISI random range=0-200 ms

Minimum reaction time start=1600 ms

Maximum time for trial=5000 ms

2. Simple Reaction Test—See FIG. 6.

Aim: to test simple reaction time as a baseline for other cognitivereaction time tests.

Simulation Phase: A simulation first shows what the subject is expectedto do. They initially see the keyboard (without hands) with the spacebar key outlined in red, a central pack of cards face-down and theresponse meter. At random intervals between 1500-2500 ms a card appearsface-up and the space bar key highlights (with an additional keypressing sound or click). A yellow shadowed arrow appears from the baseof the face-up card to the space bar key pointing to it to indicate itshould be pressed as soon as the card turns face-up. This repeats for atotal of 3 times before the demonstration ends and the test trialsbegin. The subject can abort the simulation by the escape key or othercancel sequence.

Testing Phase: The test proper is exactly the same format though thesubject must respond and no arrows appear. The sliding appearance of thehand(s) from the bottom of the screen indicates they should prepare tostart responding. In addition, the card pack, keyboard & response meterdisappear briefly and redraw. A single pack of face-down cards 33 thenappears centrally (FIG. 6) concomitantly with a shuffling sound. After avariable period, between 1500-2500 ms, a face-up card 35 (randomlyselected) appears on top of the central deck. At the same time, thespace bar key 27 highlights. These remain as they are until a key ispressed. A reaction time is then recorded, and visual feedback commences(the space bar key unhighlights and, if they correctly pressed the spacebar key, the card moves to the right turning over to face-down andslides underneath the deck or, if an incorrect key was pressed, turns tothe left initially and an error buzzer sounds). This repeats with aninter-stimulus interval (ISI) varying between 1500-2500 ms showing thesame card initially. If the trial takes longer than 5000 ms then theerror feedback occurs whether or not the subject responds. The keyboarddisappears after 3 correct consecutive trials and will reappear after 3incorrect consecutive responses. The test ends when 12 correct responseshave occurred to this same card and a further 3 correct responses tosubsequent randomly presented cards, or a total test time of 60 seconds.Hence, after 12 correct responses, the cards displayed begin to randomlychange to ensure they are aware of the importance solely of respondingwhen the card turns face-up, not the card number & suit.

This simple reaction time test is repeated 2 other times throughout thewhole test (after the combined monitoring task and at the very end afterthe associate learning task) in order to determine whether the subjectis fatiguing or concentrating more poorly as the test goes on.

Trial Settings:

Total required successes=12 (+3 extras*)

Stimulus Start=1500 ms

Stimulus Stop time=0 ms

Feedback duration=200 ms

Post-ISI random range=0-1000 ms

Minimum reaction time start=1600 ms

Maximum time for trial=5000 ms

3. Choice Reaction Test

Aim: To assess a subject's efficiency in a simple choice reaction task,here choosing between red and black alternatives. Adding this simplechoice component should increase reaction time by 50-150 msapproximately.

Simulation Phase: A simulation first shows what the subject is expectedto do. The subject initially sees the keyboard (without hands) with thetrue and false keys outlined in red, and a central pack of cardsface-down. Hence, this appearance is very similar to the simple reactiontime task just completed. At random intervals between 1500-2500 ms acard appears face-up and the correct response key highlights accompaniedby an additional key pressing sound or click. A yellow shadowed arrowappears from the base of the face-up card to the correct key pointing toit to indicate it should be pressed as soon as this type of card turnsface-up. The cards in the simulation are not proper cards, but containred or black colour filled rectangles. These are randomized in order ofpresentation during the simulation but continue until at least two ofeach have been presented and then the test proper begins.

Testing Phase: The test proper is exactly the same format using normalappearing playing cards, though the subject must respond and no arrowsappear. The sliding appearance of the hand(s) 30, 31 from the bottom ofthe computer monitor indicates they should prepare to start responding.In addition, the card pack 33 (FIG. 10) & keyboard 19 disappear brieflyand redraw. A single pack of face-down cards 33 then appears centrallyconcomitantly with a shuffling sound. After a variable period, between1500-2500 ms, a face-up card 35 (randomly selected) appears on top ofthe central deck. At the same time, the correct true/false keyhighlights. These remain as they are until a key (23, 25, 27) ispressed. A reaction time is then recorded, and visual feedback commences(the correct key unhighlights and, if they correctly pressed this key,the card moves to the right turning over to face-down and slidesunderneath the deck or, if an incorrect key was pressed, turns to theleft initially and an error buzzer sounds). This repeats with the ISIvarying between 1500-2500 ms always showing a randomly selected card. Ifa trial takes longer than 5000 ms then the error feedback occurs whetheror not the subject responds. The keyboard disappears after 3 correctconsecutive trials and will reappear after 3 incorrect consecutiveresponses. The test ends when 14 correct responses have occurred toeither red or black cards, or a total test time of 60 seconds haselapsed.

Trial Settings:

Total required successes=7 blacks+7 reds (or total of 14)

Stimulus Start=1500 ms

Stimulus Stop time=0 ms

Feedback duration=200 ms

Post-ISI random range=0-1000 ms

Minimum reaction time start=1600 ms

Maximum time for trial=5000 ms

4. Congruent Test—See FIG. 7.

Aim: To assess a subject's efficiency in a more complex choice reactiontask, here choosing between congruent card suit colours when confrontedby two face-up cards placed vertically. Adding this more complex choicecomponent should further increase reaction time by 50-150 msapproximately over the choice reaction time. This allows a regressionline to be constructed showing increasing reaction time with increasingstimulus demands.

Simulation Phase: A simulation first shows what the subject is expectedto do. They initially see the keyboard (without hands) with the true andfalse keys outlined in red, and a central pack of cards face-down whichthen splits sliding another pack of face-down cards below it. Hence,this appearance is similar to the choice reaction time task justcompleted though differing by an extra pack of face-down cards 37D. Atrandom intervals between 1500-2500 ms two cards appear face-up on theirpiles and the correct response key highlights (with an additional keypressing sound or click). A yellow shadowed arrow appears from the baseof the lowest face-up card pointing to the correct key to indicate itshould be pressed as soon as this combination of cards turn face-up. Thecards in the simulation are not proper cards, but the same red or blackcolour filled rectangle cards 37B used in the choice reaction time task.The presentation of these is again randomized during the simulation (ie.whether two congruent or different colour cards) but continues until atleast two of each configuration have been presented and then the testproper begins.

Testing Phase: The test proper is exactly the same format using normalappearing playing cards, though the subject must respond and no arrowsappear. The sliding appearance of the hand(s) from the bottom of thescreen indicates they should prepare to start responding. In addition,the card packs & keyboard disappear briefly and redraw. The dual pack offace-down cards appears again centrally concomitantly with a shufflingsound. After a variable period, between 1500-2500 ms, randomly selectedface-up cards 37C, 37D, 37E appear simultaneously on top of each deck.At the same time, the correct true/false key highlights. These remain asthey are until a key is pressed. A reaction time is then recorded, andvisual feedback commences (the correct key unhighlights and, if theycorrectly pressed this key, both cards move to the right turning over toface-down and sliding underneath the deck or, if an incorrect key waspressed, turning to the left initially with an error buzzer sounding).This sequence repeats with the ISI varying between 1500-2500 ms alwaysshowing randomly selected cards. If the trial takes longer than 5000 msthen the error feedback occurs whether or not they have responded. Thekeyboard disappears after three correct consecutive trials and willreappear after three (or more) incorrect consecutive responses. The testends when fourteen correct responses have occurred to either congruentor non-congruent card pairs, or a total test time of sixty seconds.

Trial Settings:

Total required successes=7 congruent+7 non-congruent (or total of 14)

Stimulus Start=1500 ms

Stimulus Stop time=0 ms

Feedback duration=200 ms

Post-ISI random range=0-1000 ms

Minimum reaction time start=1600 ms

Maximum time for trial=5000 ms

5. Continuous Monitoring Test—See FIG. 8.

Aim: This is the first of three linked tests. It measures vigilance andis a continuous performance task. It trains subjects in an expectantmonitoring task which is later combined with another choice decisiontask in order to test divided attention. The rule they should acquirehere is to press the space bar when any card touches a white line. Thewhite lines are horizontally placed equidistantly above and below theoriginal face-down pack's location vertically.

Simulation Phase: A simulation first shows what the subject is expectedto do. They initially see the keyboard 19 (without hands) with the spacebar key 27 outlined in red, and five vertically centred face-up cards(FIG. 13). The horizontal lines 43 are above and below these cards 41.The cards 41 move up or down continuously and seemingly randomly. Theycan thus move up at any point in time progressively, hover in the sameapproximate location or move down progressively. It is not possible topredict reliably which way a card 41 will move. All cards are constantlymoving and at some point during the simulation a card 41 touches eitherthe upper or lower limiting line. The cards 41 stop and a yellow arrowappears from bottom of the line-touching card to the space bar key whichhighlights simultaneously. After a few seconds, the demonstrationcontinues and the card which was touching the line becomes centredvertically and the space bar key unhighlights. This continues until atleast one card 41 has touched the upper and lower limit (not necessarilythe same card). The cards 41 in the simulation are proper cards.

Testing Phase: The test proper is exactly the same format, though thesubject must respond and no arrows appear. The sliding appearance of thehand(s) 30, 31 from the bottom of the screen indicates they shouldprepare to start responding. In addition, the cards 41 & keyboarddisappear briefly and redraw. The five face-up cards 41 appear againcentred vertically concomitantly with a shuffling sound and begin theirjittery pseudo-random movements up and down. After a variable period,one card 41 e will touch a line and at the same time, the space bar key27 highlights. From then onwards this card 41 e will travel away fromthe centre (but no further than a half a vertical card dimension beyondthe upper or lower white line) so that it is no longer-equivocal as towhether the line has been crossed. These continue away from the centreor at the maximum allowed limit until the space bar key 27 is pressed. Areaction time is then recorded, and visual feedback commences (the spacebar key unhighlights and, if they correctly pressed this key, the errantcard or cards re-centre). If an incorrect key is pressed, an errorbuzzer sounds and the outlier card does not change position. Inaddition, if the space bar key is pressed when no card 41 is touching orbeyond a line 43, the error buzzer also sounds and an anticipatory erroris recorded. If the subject does not respond after a card has beenbeyond a line for over two seconds, then this card jumps back a halfcard distance towards the centre and moves again outwards. This aims toattract attention to persistently missed cards. The cards 41 move eachtime with a minimum of six pixels, and variable additional steps of 0-6pixels. One “favoured” card (randomized to a different card when thisfavoured card reaches a line) has an additional gain factor (±4 pixels)added to it. If the gain factor is positive this biases movement towardsthe lower line 43 b, and if negative towards the upper line 43 a. Thekeyboard 19 disappears after three correct consecutive trials and willreappear after three (or more) incorrect consecutive responses. The testends when fourteen correct responses have occurred to either upper orlower migrating cards, or a total test time of 60 seconds.

Trial Settings:

Total required successes=14

Stimulus Start =0 ms

Stimulus Stop time=0 ms

Feedback duration=0 ms

Post-ISI random range=0 ms

Minimum reaction time start=0 ms

Maximum time for trial=99999999 ms (about 27.8 hours)

6. One-Back Test

Aims: This is the second of the three tests designed to assess dividedattention. This is a working memory task in which the subject mustremember the prior card when responding. It is termed a “one-back” testdue to the requirement to remember only the last presented card. This isalso a training task for the next combined test.

Simulation Phase: A simulation first shows what the subject is expectedto do. They initially see the keyboard 19 (without hands 30, 31) withthe true 23 and false 25 keys outlined in red, and a single central packof cards face-down above the keyboard. Hence, this appearance is similarto the choice reaction time task they have already performed. At randomintervals between 1500-2500 ms a card appears face-up on the pile andthe correct response key highlights. A yellow shadowed arrow appearsfrom the base of the face-up card pointing to the correct key toindicate it should be pressed as soon as this type of card turnsface-up. The cards in the simulation are not proper cards however, buthave red or black circles—i.e. circles of a single colour instead of thesuits, a number (or letter for J, Q, K) at the top left and the correctnumber of circles. These are meant to indicate the subject should onlybe concerned with the number of the card. The red or black filledcircles indicates that suit is not relevant to the pairing. Thesimulation items shown include all possible variations for consecutivecards. Hence, if a pair with both red, both black and either red orblack comes up and the true key is highlighted, as well asnon-sequential pairs (ie. different card face values) with the false keyhighlighted. This should be sufficient for most subjects to work out therules for responding, though this is not as easy as the prior tests. Thesimulation continues until at least one of each of the possiblesequences has appeared (and will favour these if they are not present bychance), and then the test proper begins.

Testing Phase: The test proper is exactly the same format using normalappearing playing cards, though the subject must respond and no arrowsappear. The sliding appearance of the hand(s) from the bottom of thescreen indicates they should prepare to start responding. In addition,the card pack 33 & keyboard 19 disappear briefly and redrawconcomitantly with a shuffling sound. After a variable period, between1500-2500 ms, a face-up card 35 (randomly selected) appears. At the sametime, the correct true 23/false 25 key highlights. These remain as theyare until a key 23,25,27 is pressed. A reaction time is then recorded,and visual feedback commences (the correct key unhighlights and, if theycorrectly pressed this key, the card moves to the right turning over toface-down and sliding underneath the deck or, if an incorrect key waspressed, turning to the left initially with an error buzzer sounding).This sequence repeats with the ISI varying between 1500-2500 ms alwaysshowing randomly selected cards. If the trial lasts longer than 5000 msthen the error feedback occurs whether or not they have responded. Thekeyboard disappears after three correct consecutive trials and willreappear after three (or more) incorrect consecutive responses. The testends when fourteen correct responses have occurred to either sequentialpaired or non-paired cards, or a total test time of ninety seconds.

Trial Settings:

Total required successes=14

Stimulus Start=1500 ms

Stimulus Stop time=0 ms

Feedback duration=200 ms

Post-ISI random range=0-100 ms

Minimum reaction time start=1600 ms

Maximum time for trial=5000 ms

7. Combined Monitoring/One Back Test

Aims: This is the combination of tests five & six aiming to assessdivided attention. This is a difficult task in which errors or prolongedreaction times are likely to be common. The subject must perform theone-back task occurring in the contra card, whilst observing five cardsas they jitter between the two white horizontal lines.

Simulation Phase: There is no specific simulation component to thistest. The simulation having been provided by the previous two tests. TheOne-Back task just continues from the previous test with horizontallines appearing and initiation of the jittering vertical movement of thesingle central card. After several correct responses are recorded, fourother jittering cards appear on either side of the first as in theMonitoring task. They do not change, nor are their denominationsimportant in the test. There is no keyboard at the bottom of the screenfor guidance. When the test begins the subject is expected to rememberwhich keys must be used from the previous tests.

Testing Phase: The test proper continues using exactly the same format.As before after a variable period, a card 41 or more will touch a whiteline and at the same time, the space bar key highlights. From thenonwards this card will travel away from the centre (but no further thana half a vertical card dimension beyond the upper or lower white line)so that it is no longer equivocal as to whether the line has beencrossed. These continue away from the centre or at the maximum allowedlimit until the space bar key is pressed. A reaction time is thenrecorded as for the monitoring task, and visual feedback commences (ifthey correctly press the space bar key, the errant card or cardsre-centre). If an incorrect key is pressed, which is not relevant to theone-back task, an error buzzer sounds and the outlier card does notchange position. In addition, if the space bar key is pressed when nocard is touching or beyond a line, the error buzzer also sounds and ananticipatory error is recorded. If the subject does not respond after acard has been beyond a line for over two seconds, then this card jumpsback a half card distance towards the centre and moves again outwards.This aims to attract attention to persistently missed cards. The cardsmove each time with a minimum of six pixels, and variable additionalsteps of 0-6 pixels. One “favoured” card (randomized to a different cardwhen this favoured card reaches a line) has an additional gain factor(±4 pixels) added to it. If the gain factor is positive, this biasesmovement towards the lower line, and if negative towards the upper line.

The one-back task executes simultaneously using normal appearing playingcards, though the subject must respond and no arrows appear. This taskwill seem independent of the monitoring one. After a variable period,between 1500-2500 ms, the central face-down card turns face-up cardrevealing a randomly selected card. This remains until either the trueor false key is pressed. A reaction time is then recorded, and visualfeedback commences (if they correctly pressed the true or false key, thecard moves to the right turning over to face-down and sliding underneaththe deck or, if an incorrect key was pressed, turning to the leftinitially with an error buzzer sounding). This sequence repeats with theISI varying between 1500-2500 ms always showing randomly selected cards.If the card remains face-up for longer than 5000 ms then the errorfeedback occurs whether or not they have responded.

The keyboard may appear after three incorrect consecutive responses. Thetest ends when fourteen correct responses have occurred to either upperor lower migrating cards, and fourteen correct one-back responses, or atotal test time of 90 seconds.

Trial Settings:

Total required successes=14 one-back and 14 line-crossings

Stimulus Start=1500 ms

Stimulus Stop time=0 ms

Feedback duration=200 ms

Post-ISI random range=0-1000 ms

Minimum reaction time start=1600 ms

Maximum time for trial=5000 ms

8. Paired Card Matching Test (with Incidental Memory)

Aims: To assess matching to sample speed and accuracy. Six pairs ofdifferent cards appear above a dual pack of face-down cards. Cardsappear face-up on these packs and the subject has to decide whether theyare part of the six pair legend or not. After these have been matchedmultiple times, incidental learning of these pairs is tested. Nofeedback occurs during this memory testing section. It is expected thatsubjects with poor retentive memory abilities will do particularlypoorly on the incidental memory component.

Simulation Phase: A simulation component first shows what the subject isexpected to do. They initially see the keyboard 19 (without hands 30,31) with the true and false keys outlined in red, and a single centralpack of cards face-down above the keyboard. The pack splits in two andthe second half slides below the initial pack. Cards then flip and moveupwards to form two rows of three card pairs centred horizontally abovethe face-down packs. At random intervals between 1500-2500 ms two cardsappear face-up on the piles and the correct response key 23, 25highlights. A yellow shadowed arrow appears from the base of the face-upcards pointing to the correct key to indicate it should be pressed assoon as this combination of cards turn face-up. The cards in thesimulation are proper cards. The demonstration items show both true andfalse conditions. Hence, if a pair which is also in the 6-card legendappears, this is regarded as a true condition, and a false condition iswhere a pair that is not in the key appears. To facilitate learning ofthe pairs no equivocal pairs—i.e. pairs having one of the two cards ofthe “true” legend pairs of cards—will ever appear. Visual feedbackdiffers for these conditions. For true pairs, the cards slide quickly totheir matching cards. For false conditions, the cards turn face-over andslide underneath the packs. This should allow subjects to work out therules for responding. They are not shown a simulation of the memorycomponent. The simulation continues until at least two of each of thetrue and false conditions has appeared (facilitated if chance is takingtoo long), and then the test proper begins.

Test Phase: The test proper is exactly the same format, though thesubject must respond and no arrows appear, and there are now six cardpairs 49 (ie. twelve cards in total, FIG. 14). The sliding appearance ofthe hand(s) 30, 31 from the bottom of the screen indicates they shouldprepare to start responding. In addition, the card packs & keyboarddisappear briefly and redraw concomitantly with a shuffling sound.Finally, 6-card pairs 49 are flipped over from the 2 face-down packs toindicate a new and larger set of cards will be used in the legend in thereal test. After a variable period, between 1500-2500 ms, tworandomly-selected face-up cards appear 53. At the same time, the correcttrue/false key highlights. These remain as they are until a key ispressed. A reaction time is then recorded, and visual feedback commencesas before (the correct key unhighlights and, whether they correctlypressed this key or not, the cards slide upwards to their matching cardin the legend, and if the false condition, the cards flip to the rightand slide underneath the pack). If they were incorrect in their keyresponse, an error buzzer sounds. They are not forewarned about thememory component, though it is expected that after performing the testseveral times, they will be aware of the need to commit the legend'spairs to memory. This sequence repeats with the ISI varying between1500-2500 ms always showing randomly selected card pairs either in thelegend or not, until the legend pairs have been displayed twice each,and non-legend pairs at least six times. If a trial lasts longer than5000 ms then the error feedback occurs whether or not they haveresponded. The keyboard disappears after three correct consecutivetrials and may reappear after three incorrect consecutive responses.When the learning component has completed, the incidental memorycomponent begins. This section finishes if more than 80 seconds haselapsed and moves onto the memory testing component.

The legend disappears and card pairs continue to turn over (Incidentallearning test). No error feedback is given and cards always flip over tothe right and slide under their piles regardless of the key pressed. Noerror buzzer sounds. If the subject takes longer than 5000 ms then theerror feedback occurs. About 30 successful responses are required tocomplete this test. Card pairs flip over to face-up at 1500-2500 msintervals until all legend card pairs have been shown at least once anda similar number of non-legend card pairs has appeared, or a total of150 seconds for both components has elapsed.

Trial Settings:

Total required successes=12 legend pairs, 6 foils, and then 6 of each inmemory component

Stimulus Start=1500 ms

Stimulus Stop time=0 ms

Feedback duration=200 ms

Post-ISI random range=0-1000 ms

Minimum reaction time start=1600 ms

Maximum time for trial=5000 ms

9. Associate Learning Test

Aims: This final test allows assessment of both learning & retentivememory, with a matching ability control test included. It resembles thepaired-card matching test (number 8) in layout, except that all but onepair in the legend is face-down. Thus the subject must remember thehidden cards in the pairs. The face-up pair can be matched directly bycomparison without the need to remember it. This is the control pair,since patients with primary memory disorders should be able to matcheven though they cannot recall the hidden cards. Some subjects withfeigned memory loss might be expected to have trouble with both hiddenand displayed pair matching (beyond a chance level). This is a hard testwhich should be a good discriminator of memory & concentration ability.In addition, it is presented as the last test to maximize thedetrimental effects of fatigue or poor concentration. It is alsoexpected that subjects will not recall all four pairs correctly on thefirst presentation, but that a learning curve will occur such thaterrors are corrected with subsequent feedback.

Simulation: A simulation first shows what the subject is expected to do.It is very similar to the paired-cards matching test just completed.They initially see the keyboard 19 (without hands) with the true andfalse keys outlined in red, and a single central pack of cards face-downabove the keyboard 19. The pack splits in two and the second half slidesbelow the initial pack. At random intervals between 1500-2500 ms, twocards appear face-up on the piles and the correct response keyhighlights. A yellow shadowed arrow appears from the base of the face-upcards pointing to the correct key to indicate it should be pressed assoon as this combination of cards turn face-up. The cards in thedemonstration are proper cards. The first condition is a falsecondition, since no card pairs have been seen before. The initial partof this demonstration displays each of the three pairs to be rememberedtwice in succession. The first time, when the pair is new, the false keyshould be pressed (since, to reiterate, the pair has not been seenbefore). Thereafter, if that pair appears again, the true key should bepressed. When the response has occurred, in the initial learning phase,the pair of cards slides upwards to form a grid above the dual pack ofcards. These will build into a two row by three column grid. For thedemonstration, the two outer pairs will be mainly face-down whilst thecentral pair is face-up throughout. There are three pairs in thedemonstration task. Once a pair of cards has turned over, and the arrowsremoved, the correct key unhighlights and visual feedback occurs. If thecard pair is part of the set to be remembered, the matching card pair inthe legend flip to face-up, and the stimulus cards slide to theirmatching grid position (from left to right) so the subject can see theyare the same as the new pair, wait about 0.5 seconds, and then flip overin-situ so they are face-down. The central pair in the legend, however,never turns face-down but the other similar feedback occurs.

Once all the simulation card pairs (6 cards) have appeared twice, randompresentation of pairs occurs such that either a legend's pair or anon-legend's pair appears. If the pair matches one in the legend, thetrue key highlights and is pointed to by an arrow. Once this vanishes,the cards of the pair slide to their correct positions (with firstflipping of the legend's face-down cards). If a pair appears that doesnot exactly match any of the legend's pairs, then the false key ishighlighted and the cards of the pair flip over to the right of theirpacks and then slide underneath their decks. Both unequivocal andequivocal foils (ie. with none or one only of the cards of a true legendpair respectively) can occur so that the subject must truly recall bothcards of the pair to be completely accurate. This simulation shouldallow subjects to work out the rules for responding, though they willrealize this is a difficult test. The simulation continues until atleast two of each of the true and false conditions has appeared afterall legend cards have been laid out, and then the test proper begins.

Testing Phase: The test proper is exactly the same format, though thesubject must respond and no arrows appear, and there will now be 5 cardpairs (ie. 4 face-down card pairs 61 a, 61 b, 61 c, 61 d, 61 e with acentrally placed face-up pair 61 c, FIGS. 10A and 10B). The slidingappearance of the hand(s) from the bottom of the screen indicates theyshould prepare to start responding. In addition, the card packs &keyboard 19 disappear briefly and redraw concomitantly with a shufflingsound, and the legend disappears completely. As in the demonstration,the legend's card pairs are incrementally built, as part of the learningprocess (called “drilling”) by showing a new pair 61 a, then moving itinto its grid position after a response key then repeating the same pair61 a and sliding it over the prior grid-situated pair. A card pair 61appears after a variable period between 1500-2500 ms. Card pairs areselected randomly so that no cards are repeated and no pair 61 is thesame from test to test. At the same time as the pair appears, thecorrect true/false key highlights. These remain as they are until a keyis pressed. A reaction time is then recorded, and visual feedbackcommences as discussed in the simulation except that the grid'scorresponding face-down pairs are not flipped over. The new card pairslides directly to the appropriate pile, and then flips to face-down. Ifthe pair is not part of the legend, they flip over to the right and thenslide underneath their respective packs. If the response key wasincorrect, an error buzzer sounds. This sequence repeats with the ISIvarying between 1500-2500 ms always showing randomly selected card pairseither in the legend or not, until the legend pairs have been displayedfive times each, and non-legend pairs an equal number of times. If anindividual trial lasts longer than 5000 ms then the error feedbackoccurs whether or not they have responded. The keyboard disappears afterthree correct consecutive trials and may reappear after three incorrectconsecutive responses. The test also ends if more than four minuteselapses.

Trial Settings:

Total required successes=20 legend pairs, 20 non-legend pairs

Stimulus Start=1500 ms

Stimulus Stop time=0 ms

Feedback duration=200 ms

Post-ISI random range=0-1000 ms

Minimum reaction time start=1600 ms

Maximum time for trial=5000 ms

The test can be cancelled at any time using predetermined commands. Thesubject is warned that their data will be lost if the cancel and theyare given an opportunity to change their minds.

Once the test is completed, the subject may then be asked whether theywish to e-mail the tests to a central server for analysis. The act ofsending constitutes acceptance of billing for that test. If they are notconnected directly to an active Internet connection at the time, theymay wish to defer mailing the test results. If they, or theirsupervisor, do not wish to keep the test results, they can cancel thetest. If they defer or mail the test data for analysis, the supervisordetails and test data are encrypted in accordance with a suitableencryption technique and stored in the subject data file. In addition,initial analysis occurs to create the abstracted test parametersrequired for comparison to normative data and serial performances, andthis is stored encrypted as another block in the subject file. If theycancel the process, no supervisor, test data or analysis results will bestored in their file.

In an alternative, the test is carried out “on-line” in real-time andthe results are gathered automatically by the host computer.

Normative data will be collected before final algorithms to createresults parameters are finalized. Simple descriptive statistics willcompute mean and variability measures about the mean for all testsgiving an indication of psychomotor speed and consistency. In addition,some test data will be grouped to allow across test comparisons, eg.simple reaction time, choice reaction time and congruent reaction timetest data allows a regression line, gradient and intercept to becalculated. Comparisons of monitoring and one-back tests withperformance on the combined monitoring task will be made (creating anovel parameter to measure decrement in performance due to theadditional cognitive “load”). Errors will be analyzed to give measuresof efficiency and accuracy by constructing parameters for (but notlimited to) impulsivity, perseveration, spatial (peripheral, right orleft) error scores, adaptability (initial eradication of errors),instability (return of errors once success criteria are reached), andmemory acquisition.

Combinations of these base parameters will then be tested in patientpopulations to determine whether they are sensitive to braindysfunction, and more importantly what profiles of score impairments areassociated with particular causes of brain dysfunction (depression,anxiety, psychosis, mild cognitive impairment, Alzheimer's disease,frontotemporal dementia and dysexecutive syndromes consequent to headinjury, alcohol, post-traumatic stress disorder, etc). In addition,provocative testing will be performed using normal subjects to modelsleep deprivation and fatigue, stress, alcohol, THC and benzodiazepineinduced impairment, as well as simulated disease or provocative states.These experiments will determine whether combinations of test parameterranges are sensitive to these perturbations as well as specific toindividual ailments (or limited numbers of these) to aid predictivedifferential diagnosis.

The algorithm underlying each test trial is a process which is highlyflexible. All tests use the same algorithm which can satisfy widelyvarying stimulus presentation & test requirements. This sectiondescribes the trial model and its components (FIG. 11).

Each test consists of multiple trials each of which is structured asshown in FIG. 11. The trial has component parts which are active atdifferent stages in the trial timeline. The trial settings recordcontrols exactly what these are.

The trial engine checks boolean flags to determine which part of thetimeline has been reached. When a timed interval or specific landmark isreached a corresponding function is called so the test can determine theimplementation details (including to ignore it). Idle messages are sentfrequently throughout the trial period so updates can occur or completefunctionality can be implemented from the idle function.

The trial time intervals measured from the trial start 60 (designated toin FIG. 11) are the:

-   -   fixed inter-stimulus interval (ISI fixed 50) which is the time        from t₀ 60 to stimulus start;    -   minimum reaction time (Minimum RT 51) which is the minimum time        to record a valid reaction time; any responses detected prior to        this time are designated Anticipatory responses;    -   maximum trial duration (Max. trial time 52) from t₀ 60 to trial        end (by definition).

Additional time intervals during the trial are the:

-   -   reaction time (Reaction time 53) measured from stimulus onset 61        to response detected (arrowhead) as long as the max. trial time        has not expired;    -   stimulus duration 54 from stimulus onset 61 to stimulus end;    -   feedback duration 55 from feedback onset 62 to feedback end;    -   random inter-stimulus interval (ISI random 56) measured from the        end of feedback to trial end; this is usually determined at run        time from a given maximum (eg 1000 ms such that any time from        0-1000 ms can be used).

Responses can occur at any time in the trial. If they occur prior to theMinimum RT time they are designated as Anticipatory responses, if afterstimulus onset but prior to Max. trial time a valid Reaction time isrecorded, and if after feedback has commenced are designatedPost-feedback responses. Multiple anticipatory and post-feedbackresponses can be measured but only one reaction time can be recorded.

The time from stimulus onset to feedback onset is not fixed since it isdependent upon when and whether or not a response is detected. The totalduration of the trial is guaranteed to be no more than the Max. trialtime, but can be as short as the sum of the Minimum RT, Feedbackduration and ISI random intervals. Any of the intervals can be zero,though if all are zero then the trial will occur so quickly it will noteffectively execute. However, if all intervals but the Max. trial timeare zero, the trial will effectively remain in the Post-feedbackresponse segment. Any responses detected during this time will bereported as Post-feedback responses and can be handled by the subtest inany way appropriate.

The trial also monitors for cancellation of the test either by certainkey combinations (customizable by the subtest) or expiration of thetotal duration of the test.

It will be apparent to a person skilled in the art that variousmodifications may be made to the testing method and apparatus withoutdeparting from the scope and spirit of the invention disclosed herein.

1. A psychological testing method for testing a subject, including:performing said method by means of a test presented by means of atesting means having output means and input means; and instructing saidsubject by displaying a test simulation of said test by means of saidoutput means; whereby said subject can learn how to perform said testfrom said simulation.
 2. A psychological testing method as claimed inclaim 1, including repeating said simulation a plurality of times.
 3. Apsychological testing method as claimed in claim 1, wherein said methodis performed by means of a plurality of tests, and instructing saidsubject includes displaying a test simulation of each of said pluralityof tests, whereby said subject can learn how to perform each of saidtests.
 4. A psychological testing method as claimed in claim 1, whereinsaid subject performing said test by using said input means after saidsubject is instructed.
 5. A psychological testing method as claimed inclaim 1, wherein said method includes alternating between said subjectbeing instructed and said subject performing a test.
 6. A psychologicaltesting method as claimed in claim 1, wherein said method includesterminating said instructing of said subject and commencing assessingsaid subject when said subject is able to satisfy a criterion ofcomprehension of said test.
 7. A psychological testing method as claimedin claim 6, wherein said criterion is successful performance of threeconsecutive trial tests.
 8. A psychological testing method as claimed inclaim 1, wherein said testing means is a computer programmed to carryout said method.
 9. A psychological testing method as claimed in claim1, wherein said test of said method includes displaying visual stimuli.10. A psychological testing method as claimed in claim 1, wherein saidtest of said method includes randomly varying a time at which saidvisual stimuli is displayed.
 11. A psychological testing method asclaimed in claim 1, further including measuring a response time of saidsubject.
 12. A psychological testing method as claimed in claim 11,further including disregarding a response with less than a predeterminedminimum response time.
 13. A psychological testing method as claimed inclaim 9, wherein said visual stimuli are substantially a culturalstimuli.
 14. A psychological testing method as claimed in claim 13,wherein said visual stimuli comprise representations of playing cards,dominoes, playing counters, or the like.
 15. A psychological testingmethod as claimed in claim 1, wherein displaying said test simulationincludes displaying the correct use of said input means to perform saidtest.
 16. A psychological testing method as claimed in claim 1, furtherincluding obtaining a measure of correct and incorrect responses made bysaid subject.
 17. Psychological testing apparatus for testing a subject,said apparatus including testing means having output means and inputmeans, said testing means testing said subject by presenting a test tosaid subject, said apparatus instructing said subject by displaying atest simulation of said test on said output means, whereby said subjectcan learn how to perform said test by means of said apparatus from saidsimulation.
 18. Psychological testing apparatus as claimed in claim 17,wherein said testing means is a computer programmed to present said testto said subject.
 19. Psychological testing apparatus as claimed in claim18, wherein said computer includes a host computer and a client computerconnected by a communication network.
 20. Psychological testingapparatus as claimed in claim 19, further including a memory associatedwith said host computer for storing results of said test. 21.Psychological testing apparatus as claimed in claim 19, wherein saidcommunication network is the Internet.
 22. Psychological testingapparatus as claimed in claim 18, wherein said output means is a displaymeans and more preferably a computer monitor, and said input meansincludes at least one of is a keyboard or a mouse.
 23. Psychologicaltesting apparatus as claimed in claim 17, wherein said testing meansrepeats said simulation a plurality of times.
 24. Psychological testingapparatus as claimed in claim 17 wherein there are a plurality of testsand said testing means displays a test simulation for each said test.25. Psychological testing apparatus as claimed in claim 17, wherein saidtesting means is configured to terminate instructing said subject andcommence assessment of said subject when said subject is able to satisfya criterion of comprehension of said test.
 26. Psychological testingapparatus as claimed in claim 25, wherein said criterion is successfulperformance of three consecutive trial tests.
 27. Psychological testingapparatus as claimed in claim 17 wherein said testing means presentsvisual stimuli.
 28. Psychological testing apparatus as claimed in claim17, wherein said testing means randomly varies a time at which saidvisual stimuli is displayed.
 29. Psychological testing apparatus asclaimed in claim 17, wherein said testing means measures the responsetime of said subject.
 30. Psychological testing apparatus as claimed inclaim 29, wherein said testing means disregards a response with lessthan a predetermined in a response time.
 31. Psychological testingapparatus as claimed in claim 29, wherein said tests are configured suchthat any change in response times provides a measure of fatigue of saidsubject.
 32. Psychological testing apparatus as claimed in claim 17wherein said testing means measure correct and incorrect responses madeby said subject.
 33. A psychological testing apparatus as claimed inclaim 27, wherein said testing means presents substantially a culturalstimuli to said subject.
 34. Psychological testing apparatus as claimedin claim 33, wherein said a cultural stimuli comprises representationsof playing cards, dominoes, playing counters or the like.
 35. A methodof monitoring the performance of a subject, including obtaining areference test result by a subject performing the testing method ofclaim 1 repeatedly until said subject is satisfied that they haveperformed said testing method at a near optimum level and using theresult of the test performed at a near-optimum level as a reference testresult; obtaining a comparison test result by a subject performing saidtesting method repeatedly at a time at which the subject's performanceis to be monitored until said subject is satisfied that they haveperformed the testing method at a near optimum level, and using theresult of the test performed at a near optimum level as a comparisontest result; and comparing said comparison test result with saidreference test result to thereby monitor the performance of the subject.36. A method as claimed in claim 35, further including. obtaining anumber of comparison test results and using said comparison test resultsto monitor said subject's performance.
 37. Apparatus for monitoring theperformance of a subject using the psychological testing apparatus ofclaim 17, wherein said apparatus obtains a reference test result byallowing a subject to perform the test repeatedly until said subjectprovides an input via said input means which indicates that the subjectis satisfied that they have performed said testing method at a nearoptimum level, wherein said apparatus includes a storage means forstoring said result of the test performed at a near optimum level as areference test result for said subject; said apparatus obtaining acomparison test result by allowing a subject to perform said testrepeatedly at a time at which the subject's performance is to bemonitored until said subject provides an input via said input meanswhich indicates that said subject is satisfied that they have performedthe testing method at a near optimum level, said apparatus retrievingthe stored reference test result and comparing said comparison testresult with said reference test result to thereby monitor theperformance of the subject.
 38. Use of the method of claim 35 to monitordecline in performance resulting from progression of a clinicalcondition.
 39. Use of the method of claim 35 to monitor changes inperformance resulting from therapeutic intervention following obtainmentof a reference test result.
 40. A method as claimed in claim 35 in whichdecline in performance resulting from progression of a clinicalcondition is monitored.
 41. A method as claimed in claim 35 in whichchanges in performance resulting from therapeutic intervention aremonitored.